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Previously, this was mostly a problem in Pseudomonas and Acinetobacter, but during the last decade, carbapenem resistance has escalated in medically important species such as <jats:italic>Klebsiella pneumoniae<\/jats:italic> and <jats:italic>Escherichia coli<\/jats:italic>. In particular, the rising trend in <jats:italic>E.\u00a0coli<\/jats:italic> is of concern, as this may lead to almost untreatable community\u2010acquired infections. Resistance is conferred by carbapenemases, which are beta\u2010lactamases that can breakdown essentially all beta\u2010lactams. Moreover, bacteria carrying these resistance determinants are often resistant to other treatment options, due to the frequent co\u2010acquisition of non\u2010beta\u2010lactam resistance genes located on the same mobile genetic elements. The detection of carbapenemase\u2010producing Enterobacteriaceae (<jats:styled-content style=\"fixed-case\">CPE<\/jats:styled-content>) is a challenge, because some carbapenemases produce relatively discrete levels of carbapenem resistance. Current clinical evidence for treatment guidance is limited and based on retrospective observational studies and case reports. Existing data support the use of combination therapy for treatment of severe infections caused by <jats:styled-content style=\"fixed-case\">CPE<\/jats:styled-content>. Combination regimens including colistin, carbapenems, tigecycline, aminoglycosides and fosfomycin have been used. Randomized controlled studies of combination regimens are ongoing and may help to determine the optimal therapy. Novel beta\u2010lactamase inhibitors may also have a role in future treatment of these infections. Strict infection control measures including isolation or cohort care of affected patients as well as contact tracing and active screening are needed to curb the spread of <jats:styled-content style=\"fixed-case\">CPE<\/jats:styled-content>. In this review, we provide a clinical perspective on the management of patients infected or colonized with <jats:styled-content style=\"fixed-case\">CPE<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/joim.12342","type":"journal-article","created":{"date-parts":[[2014,12,30]],"date-time":"2014-12-30T03:40:49Z","timestamp":1419910849000},"page":"501-512","source":"Crossref","is-referenced-by-count":280,"title":["Global dissemination of extensively drug\u2010resistant carbapenemase\u2010producing <scp>E<\/scp>nterobacteriaceae: clinical perspectives on detection, treatment and infection control"],"prefix":"10.1111","volume":"277","author":[{"given":"T.","family":"T\u00e4ngd\u00e9n","sequence":"first","affiliation":[{"name":"Department of Medical Sciences Section of Infectious Diseases Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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